Maximus offers multiple protocols because no single approach is right for every client. This article walks through the major decision points so you can come to your clinical evaluation prepared. Your clinician makes the final recommendation based on your labs, medical history, and goals.
Testosterone protocols — the main decision
The testosterone cluster has four primary options. They differ in how testosterone is delivered (or stimulated), how quickly results show up, and whether natural production is preserved.
Quick comparison
Protocol | How it works | Format | Time to effect | Preserves natural T production |
Enclomiphene | Stimulates your body's own testosterone via LH/FSH signaling | Daily oral pill | 1.5–2 months | Yes (mechanism preserves HPTA) |
Oral Testosterone | Bioidentical testosterone absorbed through the lymphatic system | 3–4 daily oral pills | Days to weeks for symptoms; weeks for full effect | Yes (per Maximus N=34 study, 100% maintained LH/FSH) |
Topical Testosterone | Bioidentical testosterone applied as cream or gel | Daily cream or gel | Weeks for full effect | Yes when combined with Enclomiphene |
Injectable Testosterone | Bioidentical testosterone via intramuscular or subcutaneous injection | Weekly or twice-weekly injection | Days to weeks | Suppresses natural production unless combined with Enclomiphene or hCG |
If you want to…
Preserve fertility above all else → Enclomiphene standalone is the simplest answer. Oral, Topical, or Injectable Testosterone combined with Enclomiphene also preserves fertility per Maximus published research.
Avoid injections and creams → Enclomiphene or Oral Testosterone.
Get the strongest measurable testosterone increase → Injectable Testosterone (often combined with Enclomiphene or hCG) typically produces the highest measurable T levels.
Try the lowest-commitment option first → Enclomiphene. It's oral, once-daily, fertility-preserving, and has the largest Maximus published dataset (N=1,250).
Skip the video evaluation → Enclomiphene or Oral Testosterone. Injectable and Topical Testosterone require a video evaluation due to additional regulatory requirements.
For published study findings across these protocols, see Maximus Clinical Research.
Other protocol decisions
Weight Loss (semaglutide vs. tirzepatide)
Maximus prescribes both GLP-1 medications. Your clinician determines which is appropriate based on:
Your medical history
Tolerance and response
Goals
Tirzepatide is a dual GLP-1 + GIP receptor agonist; semaglutide acts on the GLP-1 receptor only. Pricing differs by medication (see Weight Loss Plan Pricing). Both are fulfilled through licensed 503A compounding pharmacies (see Compounding Pharmacies at Maximus).
Hair Improvement Protocol (topical, oral, or combination)
The Hair Improvement Protocol uses topical formulations, oral medications, or both. Your clinician determines the mix based on:
The pattern and stage of hair thinning
Your medical history
Sensitivity to specific medications
For details on what's included, see Hair Improvement Protocol: Overview.
Blood Flow (tadalafil, sildenafil, or vardenafil)
All three are PDE-5 inhibitors. They differ in onset and duration:
Tadalafil — longer-acting; supports circulation over an extended window
Sildenafil — shorter-acting; works within a more time-limited window
Vardenafil — rapid-onset; may begin working more quickly for some
Your clinician selects based on your health profile and how you want the medication to work.
Growth Hormone (Sermorelin and Tesamorelin)
Maximus offers Sermorelin (low and high intensity) and Tesamorelin. Your clinician selects based on your goals, clinical profile, and how your body responds.
Combining protocols
Many Maximus protocols can be used together. Common combinations:
Enclomiphene + Tadalafil — same price as standalone Enclomiphene with added blood-flow support
Enclomiphene + Topical, Oral, or Injectable Testosterone — dual-mechanism for testosterone optimization with fertility preservation
Testosterone + Hair Improvement Protocol — addressing DHT-related hair changes alongside T optimization
Weight Loss + Building Blocks — supports the nutritional side of metabolic protocols
Sermorelin + Testosterone — supports growth hormone alongside T optimization
Your clinician confirms compatibility based on your labs and overall health profile.
What your clinician considers
When your clinician recommends a protocol, they evaluate:
Your current labs (testosterone, LH, FSH, estradiol, PSA, CBC, and others depending on the protocol)
Symptoms and goals
Medical history (cardiovascular, liver, kidney, mental health)
Current medications and supplements
Fertility considerations
Lifestyle factors (daily pills vs. weekly injections, etc.)
How you've responded to similar protocols before
This is why your intake questionnaire and labs matter — they give your clinician the information needed to recommend the right protocol for you.
Common questions
Can I pick the protocol myself? You can express a preference at intake. Your clinician confirms whether your preferred protocol is appropriate based on your labs and medical history. If it's not appropriate, they'll explain why and recommend alternatives.
Can I switch protocols later? Yes. For testosterone, see How to Switch or Modify Your Testosterone Subscription for the switching process and cost implications. For other protocols, message your clinician.
Is Enclomiphene "weaker" than testosterone replacement? Different, not weaker for everyone. The Maximus Enclomiphene Protocol study (N=1,250) showed an average 89.7% increase in free testosterone while preserving natural production. For some clients, that's the right answer. For others with more severe low-T symptoms, testosterone replacement may be more appropriate. Your clinician determines what fits your situation.
Do I have to choose just one protocol? No. See "Combining protocols" above for common combinations.
Where do I find pricing? Each protocol has its own pricing article: Enclomiphene Subscription Plans & Pricing, Weight Loss Plan Pricing, and so on.